Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients

Tanya S. Johns, Michelle M. Estrella, Deidra C. Crews, Lawrence J. Appel, Cheryl A M Anderson, Patti L. Ephraim, Courtney Cook, L. Ebony Boulware

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Young blacks receiving dialysis have an increased risk of death compared with whites in the United States. Factors influencing this disparity among the young adult dialysis population have not been well explored. Our study examined the relation of neighborhood socioeconomic status (SES) and racial differences in mortality in United States young adults receiving dialysis.We merged US Renal Data System patient-level data from 11, 027 black and white patients ages 18 - 30 years old initiating dialysis between 2006 and 2009 withUS Census data to obtain neighborhood poverty information for each patient. We defined low SES neighborhoods as those neighborhoods in US Census zip codes with ≥20% of residents living below the federal poverty level and quantified race differences in mortality risk by level of neighborhood SES. Among patients residing in low SES neighborhoods, blacks had greater mortality than whites after adjusting for baseline demographics, clinical characteristics, rurality, and access to care factors. This difference in mortality between blacks and whites was significantly attenuated in higher SES neighborhoods. In the United States, survival between young adult blacks and whites receiving dialysis differs by neighborhood SES. Additional studies are needed to identify modifiable factors contributing to the greater mortality among young adult black dialysis patients residing in low SES neighborhoods.

Original languageEnglish (US)
Pages (from-to)2649-2657
Number of pages9
JournalJournal of the American Society of Nephrology
Volume25
Issue number11
DOIs
StatePublished - Nov 1 2014

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Social Class
Dialysis
Young Adult
Mortality
Censuses
Poverty
Information Systems
Demography
Kidney
Survival
Population
hydroquinone

ASJC Scopus subject areas

  • Nephrology

Cite this

Johns, T. S., Estrella, M. M., Crews, D. C., Appel, L. J., Anderson, C. A. M., Ephraim, P. L., ... Boulware, L. E. (2014). Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients. Journal of the American Society of Nephrology, 25(11), 2649-2657. https://doi.org/10.1681/ASN.2013111207

Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients. / Johns, Tanya S.; Estrella, Michelle M.; Crews, Deidra C.; Appel, Lawrence J.; Anderson, Cheryl A M; Ephraim, Patti L.; Cook, Courtney; Boulware, L. Ebony.

In: Journal of the American Society of Nephrology, Vol. 25, No. 11, 01.11.2014, p. 2649-2657.

Research output: Contribution to journalArticle

Johns, TS, Estrella, MM, Crews, DC, Appel, LJ, Anderson, CAM, Ephraim, PL, Cook, C & Boulware, LE 2014, 'Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients', Journal of the American Society of Nephrology, vol. 25, no. 11, pp. 2649-2657. https://doi.org/10.1681/ASN.2013111207
Johns, Tanya S. ; Estrella, Michelle M. ; Crews, Deidra C. ; Appel, Lawrence J. ; Anderson, Cheryl A M ; Ephraim, Patti L. ; Cook, Courtney ; Boulware, L. Ebony. / Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients. In: Journal of the American Society of Nephrology. 2014 ; Vol. 25, No. 11. pp. 2649-2657.
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